Orr S T, Miller C A
Med Care. 1981 Jun;19(6):583-90. doi: 10.1097/00005650-198106000-00002.
Many sources of data confirm that utilization of health services by poor children has increased since the advent of Medicaid in 1966. Poor children make approximately the same number of visits to medical provides each year as do non-poor children. Considering the greater need for services among poor children, few suggest that their full need is met. Available data are not entirely adequate to document how or where the increased utilization has occurred. The Medicaid legislation appeared to presume that poor children would be "mainstreamed" into the same provider systems that are used by the non-poor. Data from national and local surveys are cited in support of the possibility that Medicaid has in fact had a paradoxical effect, proportionately increasing publicly sponsored provider systems, and proportionately decreasing poor children's utilization of private medical providers.
许多数据来源证实,自1966年医疗补助计划问世以来,贫困儿童对医疗服务的利用率有所提高。贫困儿童每年去看医疗服务提供者的次数与非贫困儿童大致相同。考虑到贫困儿童对服务的需求更大,很少有人认为他们的全部需求得到了满足。现有的数据并不完全足以记录利用率提高是如何发生的以及发生在哪里。医疗补助计划立法似乎假定贫困儿童将被“纳入主流”,进入与非贫困儿童相同的医疗服务提供者体系。引用了来自全国和地方调查的数据来支持这样一种可能性,即医疗补助计划实际上产生了一种自相矛盾的效果,按比例增加了公共资助的医疗服务提供者体系,同时按比例减少了贫困儿童对私人医疗服务提供者的利用率。